Lose the attitude, the fat will follow

The pressure to fudge and obfuscate is heavy, but in Britain some brave doctors are finally calling their increasingly porky patients fat, or precisely, obese.

The medics are tired of being hectored by health professionals and do-gooders dedicated to making excuses for lazy, big-bellied Brits demanding that the National Health Service pay in the billions for pills and bariatric surgery instead of changing their lifestyles and attitudes.

Champion of calling a gigantic spade a spade and taking personal responsibility rather than posing as a victim is Dr
Max Pemberton
.

In a powerful column for The Spectator titled “Obesity is not a disease" that sparked a lively debate, he rejected guidelines urging doctors not to blame patients for their excess kilograms and avoid even using terms like obese in case they upset them (apparently they should be advised politely to seek a “healthier weight").

In a series of alarming anecdotes the good doc described the legions of patients pouring into GPs’ surgeries ‘‘who are not interested in changing their diet in any way, demanding to have their cake, eat it and then pop a pill so that the calories never touch their waistline. And as a result, Britain now combines austerity with obesity.’

It is always someone else’s fault, and the public health services, local councils, emergency and ambulance services, like airlines, must simply adapt to ballooning girths, by building larger operating tables, bigger seats, giant stretchers and even oversized diagnostic machines.

There are, ahem, huge parallels with the Australian debate, as we are on some measures even fatter than our British cousins. New figures show that using the waist circumference measure, a whopping 40 per cent of Australians are obese – well above the 27 per cent commonly cited using the conventional Body Mass Index (BMI).

Junk food industries

Still, Melbourne University professor of public health
Rob Moodie
was reported as castigating the Abbott government for preaching too much personal responsibility instead of going after the junk food industries as ‘‘modern-day vectors of disease, just as mosquitoes might be for malaria’’.

Moodie, who chaired the Rudd government’s national preventive health taskforce, is right about the need for changes to the way junk food is made available and marketed to kids.

Yet surely the causes of our obesity epidemic have a great deal to do with children and adults growing accustomed to shovelling more processed food into their mouths than can be burnt off in the minimal movements they execute sitting in their cars, or on couches glued to their smartphones and tablets.

The shame associated with being a fat kid or adult in an era of mass obesity has all but disappeared (all helped along by the hysterics crying “body shaming" any time any one mentions that someone is unhealthily overweight).

“The worst of it is attitude’’ rather than lifestyle changes, Pemberton wrote. ‘‘People just aren’t bothering to lose weight any more. Perhaps obesity is viewed as more normal. But this is also down to the attitude that we doctors increasingly encounter in our consulting rooms: the reluctance of patients to accept that ailments can be blamed on their behaviour, for which they are reluctant to take responsibility.

‘‘Patients blame obesity on the government, cunning food [makers], their parents and their genes.’’

Meanwhile, parents are no longer embarrassed to post photos of their fat primary-school-aged and older kids.

A decade or two ago, things were different, but today most find it unremarkable that many little kiddies have protruding pot bellies, back fat and double chins. And who would dare mention such things to mums and dads who on any other score – like vaccinating their kids or making sure they go to school – are harshly judged. But if you point out the obvious, you are a fattist of course!

Parents too slack, tired or politically correct

We see them in the showers at the swimming pool and on the pages of Facebook. And whose heart cannot go out to these wretched children whose parents are too slack, tired or politically correct to care enough about their kids’ health and what their adulthood will be like. It is especially upsetting when the parent is reasonably slim, but then one must wonder if their significant other is off the scales and won’t put themselves or their kids on healthy rations.

Sensible guidelines and transparency on calorie content, and limits on sugar and transfats are in order (the New York Mayor Bloomberg approach). Still, the fat and obese should be advised as early as possible about the health and personal risks of what is ultimately their personal choice and behaviour. Hurt feelings are a low price to pay if they can get out of their cycle of hefty annual weight gain.

In the case of kids the parents also must be made responsible. That can involve education and all kinds of creative interventions.

Wouldn’t it be a fabulous food revolution if our schools actually provided French-style healthy, balanced meals to children from preschool age (that parents pay for on a sliding scale according to income).

They could avoid the horrid tuckshop and plastic lunchbox of sandwiches eaten on benches, which is no way to educate the young in how to eat well, for pleasure as well as health and wellbeing, in the company of others at a table.

The parents of Australian baby boomers knew something that parents today don’t know. Most of them came from pretty humble backgrounds, given that’s what life was like. And yet they knew about the Oslo lunch, and how not to stuff their kids with lollies and chips. They also walked a lot, could not always afford to take cars and taxis, and were concerned if they did put weight on unlike their bulging, swollen-girthed “let it all go" offspring. We should be taking them as healthy role models rather than railing constantly at some nefarious external fast food force obliging us to turn into a nation of fatties.